Bolus Texture Testing as a Clinical Method for Evaluating Food Oral Processing and Choking Risk: A Pilot Study

Bandini, Andrea; Gandhi, Pooja; Sutton, Danielle; Steele, Catriona M.

doi:10.1044/2022_ajslp-22-00014

Cited by 3 publications

(1 citation statement)

References 38 publications

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“…The capsules are larger than those (15 mm) described as a possible cause of choking (53) . This possibility must be considered in the case of older individuals and patients with dysphagia.…”

Section: Discussionmentioning

confidence: 76%

Videofluoroscopic Evaluation of the Impact of Capsule Size and Subject’s Age and Gender on Capsule Swallowing

GUTIERRES,

MONTALDI,

NASCIMENTO

et al. 2024

Arq. Gastroenterol.

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Background: People recurrently have difficulties swallowing solid medications, which can be associated with the size of the medication and the age and gender of individuals. Objective: To evaluate the impact of capsule size and adults’ age and gender on oral and pharyngeal capsule transit during capsule swallows. Methods: Videofluoroscopy was used to measure capsule oral and pharyngeal transit during swallows in 49 healthy individuals (17 men and 32 women), with a mean age of 46 years (ranging from 23 to 88 years). Smaller capsules were filled with 0.50 mL of barium sulfate, and larger capsules were filled with 0.95 mL of barium sulfate; the volume of liquid ingested with the capsules was also quantified in each ingestion. The measurements included the oral preparation time, oral transit time, swallowing reaction time, time to laryngeal vestibule closure, laryngeal vestibule closure duration, pharyngeal transit time, and upper esophageal sphincter opening duration. Results: The capsule size did not influence either the oral or pharyngeal transit time. Increased liquid volume was ingested with larger capsules and by people older than 40 years. The oral transit time was shorter in older adults (60-88 years), and the time to laryngeal vestibule closure was longer in women. Conclusion: The size of large capsules did not make a difference in oral or pharyngeal transit when compared with smaller capsules. The capsule size and the participant’s age influenced the volume of liquid ingested - larger capsules and older individuals required a larger volume. The capsule oral transit was faster in individuals older than 60 years.

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Section: Discussionmentioning

confidence: 76%

Videofluoroscopic Evaluation of the Impact of Capsule Size and Subject’s Age and Gender on Capsule Swallowing

GUTIERRES,

MONTALDI,

NASCIMENTO

et al. 2024

Arq. Gastroenterol.

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A Preliminary Study of Vallecular Bolus Aggregation in Healthy Swallowing of Solid Food Boluses

Gandhi,

Barrett,

Mancopes

et al. 2024

J Speech Lang Hear Res

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Objective: The pharyngeal swallow typically begins within 400 ms following the arrival of a liquid bolus in the pharynx. By contrast, processed food particles aggregate in the valleculae prior to swallow initiation. With solid foods, swallow reaction time (SRT), the interval between bolus passing the ramus of mandible and hyoid burst onset (HYB) can be subdivided into components of vallecular aggregation time (VAT) and the subsequent end of aggregation to hyoid burst interval (EOA-to-HYB). However, expected durations of these timing measures remain unclear. We aimed to study bolus aggregation in healthy swallowing for International Dysphagia Diet Standardisation Initiative Food Levels 5 (minced and moist [MM5]), 6 (soft and bite-sized [SB6]), and 7 (regular [RG7]). Understanding typical patterns and durations of vallecular aggregation with solids in healthy swallowing will inform the identification of impaired swallow timing in patient populations. Design: Twenty healthy adults (10 males, M age = 28 years, range: 23–55 years) swallowed two boluses each of MM5, SB6, and RG7 foods in videofluoroscopy. Blinded duplicate ratings determined bolus location at swallow onset, SRT, VAT, and EOA-to-HYB. Texture-based differences were measured using Friedman's tests. Bolus location was at/above the valleculae at swallow onset for 85% of boluses, with no differences by texture. SRT, VAT, and EOA-to-HYB did not vary by texture, with overall median values (interquartile range) of 99 ms (−66 to 743 ms) for SRT, 347 ms (66 to 891 ms) for VAT, and −132 ms (−231 to −83 ms) for EOA-to-HYB. Conclusions: These data corroborate prior evidence that it is not unusual for food particles to aggregate in the valleculae prior to swallow initiation in healthy swallowing. However, durations of vallecular aggregation are typically < 1 s in healthy adults.

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Oral health research: Dysphagia is an important issue

Pedrolli

2023

Gerodontology

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Bolus Texture Testing as a Clinical Method for Evaluating Food Oral Processing and Choking Risk: A Pilot Study

Cited by 3 publications

References 38 publications

Videofluoroscopic Evaluation of the Impact of Capsule Size and Subject’s Age and Gender on Capsule Swallowing

Videofluoroscopic Evaluation of the Impact of Capsule Size and Subject’s Age and Gender on Capsule Swallowing

A Preliminary Study of Vallecular Bolus Aggregation in Healthy Swallowing of Solid Food Boluses

Oral health research: Dysphagia is an important issue

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